Identifying priority gaps in contextual factors research and force-based manipulation. An international and interdisciplinary Delphi study

ABSTRACT

Objective

To establish priority gaps related to contextual factors (CFs) research and force-based manipulation (FBM)

Methods

A three-round Delphi following recommended guidelines for conducting and reporting Delphi studies (CREDES) involving international and interdisciplinary panelists with expertise in CFs and FBM. Round 1 was structured around two prompting questions created by the workgroup. Ranking of each priority gap was done by calculating composite scores for each theme generated. Consensus threshold was set with an agreement ≥75% among panelists. Median and interquartile range were calculated for each priority gap to provide the central tendency of responses. Wilcoxon rank-sum test was used to evaluate the consistency and stability of responses between rounds 2 and 3.

Results

Forty-six panelists participated in all three rounds of the Delphi. Consensus was reached for 16 of 19 generated themes for priority gaps in CFs research and FBM. The ranking of each identified gap was computed and presented. Wilcoxon rank-sum test was non-significant (P > .05), demonstrating consistency and stability of results between rounds.

Conclusion

The result of this Delphi provides international and interdisciplinary consensus-based priority gaps in CFs research and FBM. The gaps identified can be used to generate future research inquiries involving CFs research and FBM.

KEYWORDS:

• Contextual factors
• Delphi study
• force-based manipulation
• manual therapy
• priority gaps
• outcomes

Disclosure statement

David Griswold teaches continuing education seminars in manual therapy and dry needling.

Chad Cook is the Director of the Center of Excellence in Manual and Manipulative Therapy at Duke University, and a portion of his salary is supported by that role. Chad published a book on OMT and a course with AGENCE EBP on Manual Therapy in which he receives royalties. He is also a consultant for the Hawkins Foundation, Zimmer Biomedical, and Akron Children’s.

Giacomo Rossettini leads education programs on placebo, nocebo effects and contextual factors in healthcare to under- and post-graduate students along with private CPD courses.

Additional information

Funding

No funding sources to disclose.

Notes on contributors

David Griswold

David Griswold PT, DPT, PhD is a Distinguished Associate Professor in the Department of Graduate Studies in Health & Rehabilitation Sciences at Youngstown State University. He completed his Doctorate of Physical Therapy from Youngstown State University and his Doctorate of Philosophy in Physical Therapy from Nova Southeastern University. He has more than 10 peer-reviewed publications in manual therapy and dry needling and is a national speaker and instructor in dry needling.

Ken Learman

Ken Learman, PT, PhD, FAAOMPT is a Distinguished Professor in the Department of Graduate Studies in Health & Rehabilitation Sciences at Youngstown State University. He is the director for the Doctorate in Health Sciences along with teaching EBP and orthopedic manual therapy in the DPT program. With 34 years of OMT experience, he is a senior deputy editor for the Journal of Manual and Manipulative Therapy and has served as a reviewer for more than a dozen other journals. He has published over 40 manuscripts, 7 book chapters and co-edited an orthopedic cases textbook.

Giacomo Rossettini

Giacomo Rossettini, PhD, PT, is a clinical physiotherapist, researcher, and lecturer from Italy. He earned his PhD at the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health - University of Genova in 2018, with a thesis on “Contextual Factors, Placebo And Nocebo Effects In Physical Therapy: Clinical Relevance And Impact On Research”. Giacomo Rossettini is the author of over 70 peer-reviewed publications in physiotherapy journals. He has given over 60 presentations at universities and national and international conferences. His didactic, clinical, and scientific interests concern the field of musculoskeletal rehabilitation, with an emphasis on placebo and nocebo effects, contextual factors, patient’s expectation and preferences.

Alvisa Palese

Alvisa Palese, RN, MNS, PhD. She is Full Professor in Nursing, at serves as the Dean of the Bachelor of Nursing Science, and in the Master of Nursing and Midwifery Sciences, in Udine University and Udine/Trieste University Italy. She completed her Doctor of Nursing Science in Hull (UK). She published over than 400 peer reviewed journal articles and passionate in research.

Edmund Ickert

Edmund Ickert PT, DPT, PhD, CLT serves as an Assistant Professor in the Doctor of Physical Therapy Program at Youngstown State University. He completed his Doctor of Physical Therapy and Doctor of Philosophy in Health Sciences from Youngstown state University in Ohio. Dr. Ickert’s scholarship includes over 5 peer reviewed journal articles and he has served as a peer reviewer for multiple journals.

Mark Wilhelm

Mark Wilhelm PT, DPT, PhD, serves as the Director of Admissions and Associate Professor in the Doctor of Physical Therapy Program at Tufts University School of Medicine. He completed his Bachelor of Science in Exercise Science from the University of Akron, his Doctor of Physical Therapy from Walsh University in Ohio, and his Doctor of Philosophy in Rehabilitation Sciences from Texas Tech University Health Sciences Center. Dr. Wilhelm’s scholarship includes over 20 peer reviewed journal articles and he has co-authored two book chapters.

Chad Cook

Chad Cook PT, PhD, FAPTA is a Professor in the Department of Orthopaedic Surgery in Duke University. He also has appointments in Population Health Sciences and the Duke Clinical Research Institute. Dr. Cook is an NIH and DoD funded researcher and is the Director of the Duke Center of Excellence in Manual and Manipulative Therapy.

Jennifer Bent

Jennifer Bent, MPT, CMTPT, OCS, FAAOMPT is a board-certified orthopedic physical therapist with over 10 years of experience in the management of acute and chronic musculoskeletal conditions at Duke University Healthcare System using a contemporary approach to rehabilitation. She completed her Bachelor of Science in Exercise Science with a minor in Sport Coaching from UNC-Greensboro, her Master’s degree in Physical Therapy from Winston Salem State University. She is a Fellow of the American Academy of Orthopedic Manual Therapists and a graduate of the Myopain Seminar Series.